END OF WORDS: DR SHRINIWAS KASHALIKAR

Communication evolves from nonverbal to verbal but it fails to communicate completely and accurately. This is true even in the best of speeches, drafts and literature.
As a result; words often create misunderstanding and/or conflicts, which are variably violent.
But the words obviously serve the purpose of communication and hence cannot be abandoned.
What we talk or write; may not convey exactly what we feel due to our inability and also due the differing constitutions of the people. This is because our feelings from our interior are first filtered through our subjectivity and subsequently filtered through the subjectivity of the others.
Our passions, obsessions, missions, desires, goals and aspirations are subjective and inaccurate. When we go beyond actions and words, born out of them; we reach our true desire, which is objective, selfless and hence is the same; as cosmic, divine or God’s desire.
NAMASMARAN is a process of going into syncytium of interiors; common to all; and without separating barriers! It is the controlling source of all actions, passions, feelings, thoughts, words and articulations; including the holistic concepts!
Whereas various enlightened actions, speeches and writings are useful; they are inadequate and feeble; as compared to this vibrant, vitalizing and uniting source of universe; NAMA, Guru, the true self; accessible trough NAMASMARAN. Hence NAMASMARAN is called the truest SAT KARMA (Action that takes us to the absolute truth).

What is difficulty swallowing
Difficulty swallowing is also called dysphagia. It is usually a sign of a problem with your throat or esophagus -the muscular tube that moves food and liquids from the back of your mouth to your stomach. Although dysphagia can happen to anyone, it is most common in older adults, babies, and people who have problems of the brain or nervous system.
There are many different problems that can prevent the throat or esophagus from working properly. Some of these are minor, and others are more serious. If you have a hard time swallowing once or twice, you probably do not have a medical problem. But if you have trouble swallowing on a regular basis, you may have a more serious problem that needs treatment.
What causes dysphagia?
Normally, the muscles in your throat and esophagus squeeze, or contract, to move food and liquids from your mouth to your stomach without problems. Sometimes, though, food and liquids have trouble getting to your stomach. There are two types of problems that can make it hard for food and liquids to travel down your esophagus:
The muscles and nerves that help move food through the throat and esophagus are not working right. This can happen if you have:
Had a stroke or a brain or spinal cord injury.
Certain problems with your nervous system, such as post-polio syndrome, multiple sclerosis, muscular dystrophy, or Parkinson's disease.
An immune system problem that causes swelling (or inflammation) and weakness, such as polymyositis or dermatomyositis.
Esophageal spasm. This means that the muscles of the esophagus suddenly squeeze. Sometimes this can prevent food from reaching the stomach.
Scleroderma. In this condition, tissues of the esophagus become hard and narrow. Scleroderma can also make the lower esophageal muscle weak, which may cause food and stomach acid to come back up into your throat and mouth.
Something is blocking your throat or esophagus. This may happen if you have:
Gastroesophageal reflux disease (GERD). When stomach acid backs up regularly into your esophagus, it can cause ulcers in the esophagus, which can then cause scars to form. These scars can make your esophagus narrower.
Esophagitis. This is inflammation of the esophagus. This can be caused by different problems, such as GERD or having an infection or getting a pill stuck in the esophagus. It can also be caused by an allergic reaction to food or things in the air.
Diverticula. These are small sacs in the walls of the esophagus or the throat.
Esophageal tumors. These growths in the esophagus may be cancerous or not cancerous.
Masses outside the esophagus, such as lymph nodes, tumors, or bone spurs on the vertebrae that press on your esophagus.
A dry mouth can make dysphagia worse. This is because you may not have enough saliva to help move food out of your mouth and through your esophagus. A dry mouth can be caused by medicines or another health problem.
What are the symptoms?
Dysphagia can come and go, be mild or severe, or get worse over time. If you have dysphagia, you may:
Have problems getting food or liquids to go down on the first try.
Gag, choke, or cough when you swallow.
Have food or liquids come back up through your throat, mouth, or nose after you swallow.
Feel like foods or liquids are stuck in some part of your throat or chest.
Have pain when you swallow.
Have pain or pressure in your chest or have heartburn.
Lose weight because you are not getting enough food or liquid.
How is dysphagia diagnosed?
If you are having difficulty swallowing, Dr. B C Shah will ask questions about your symptoms and examine you. He or she will want to know if you have trouble swallowing solids, liquids, or both. He or she will also want to know where you think foods or liquids are getting stuck, whether and for how long you have had heartburn, and how long you have had difficulty swallowing. He or she may also check your reflexes, muscle strength, and speech. Dr. B C Shah may then refer you to one of the following specialists:
An otolaryngologist, who treats ear, nose, and throat problems
A gastroenterologist, who treats problems of the digestive system
A neurologist, who treats problems of the brain, spinal cord, and nervous system
A speech-language pathologist, who evaluates and treats swallowing problems
To help find the cause of your dysphagia, you may need one or more tests, including:
X-rays. These provide pictures of your neck or chest.
A barium swallow. This is an X-ray of the throat and esophagus. Before the X-ray, you will drink a chalky liquid called barium. Barium coats the inside of your esophagus so that it shows up better on an X-ray.
Fluoroscopy. This test uses a type of barium swallow that allows your swallowing to be videotaped.
Laryngoscopy. This test looks at the back of your throat, using either a mirror or a fiber-optic scope.
Esophagoscopy or upper gastrointestinal endoscopy. During these tests, a thin, flexible instrument called a scope is placed in your mouth and down your throat to look at your esophagus and perhaps your stomach and upper intestines. Sometimes a small piece of tissue is removed for a biopsy. A biopsy is a test that checks for inflammation or cancer cells.
Manometry. During this test, a small tube is placed down your esophagus. The tube is attached to a computer that measures the pressure in your esophagus as you swallow.
pH monitoring, which tests how often acid from the stomach gets into the esophagus and how long it stays there.
How is it treated?
Your treatment will depend on what is causing your dysphagia. Treatment for dysphagia includes:
Exercises for your swallowing muscles. If you have a problem with your brain, nerves, or muscles, you may need to do exercises to train your muscles to work together to help you swallow. You may also need to learn how to position your body or how to put food in your mouth to be able to swallow better.
Changing the foods you eat. Dr. B C Shah may tell you to eat certain foods and liquids to make swallowing easier.
Dilation. In this treatment, a device is placed down your esophagus to carefully expand any narrow areas of your esophagus. You may need to have the treatment more than once.
Endoscopy. In some cases, a long, thin scope can be used to remove an object that is stuck in your esophagus.
Surgery. If you have something blocking your esophagus (such as a tumor or diverticula), you may need surgery to remove it. Surgery is also sometimes used in people who have a problem that affects the lower esophageal muscle (achalasia).
Medicines. If you have dysphagia related to GERD, heartburn, or esophagitis, prescription medicines may help prevent stomach acid from entering your esophagus. Infections in your esophagus are often treated with antibiotic medicines.
In rare cases, a person who has severe dysphagia may need a feeding tube because he or she is not able to get enough food and liquids.

A
HOLISTIC PRESCRIPTION

DR.SHRINIWAS KASHALIKAR
As we go on evolving; we begin to appreciate that a doctor’s prescription has to be aimed at healing; the body, instincts, emotions, motivations, thoughts, vision and behavior of an individual; and also the society.
This is because; just as the health of an individual affects the health of society; the vice versa is also true. Not only the international, national, regional and local policies, plans and programs in health care (which obviously influence the health of an individual); but also; those in different fields; such as education, agriculture, industry; influence the health of an individual.
Hence ideally; the prescription should include guidelines; to the patient; about preventive and curative measures; but also to the policy makers of health care and other fields.
However; all the details of such guidelines cannot be expected from the treating doctor, who is trained merely in a particular field of medicine such as Homeopathy, Naturopathy, Ayurveda or Allopathy.
In such a situation; there has to be a “key instruction” that can “inspire” the appropriate guidelines in the patient (who may be a policy maker of education, practice, research, production and marketing; in all health care and other fields; or a common individual).
The essential core of such key instruction has to be; its potential to “free” any individual; from subjective and sectarian perspective, thinking, policy making, planning and behavior; and empower him or her to be objective and holistic and conceive the appropriate preventive and curative measures.
After decades of extensive study, research and experimentation for such a “key instruction”, which would be common to all prescriptions and making them holistic; I found one; to my satisfaction. This “key instruction” is nothing else; but the traditional, simple, inexpensive and universally practicable practice of NAMASMARAN (JIKRA, JAAP, JAP, SIMARAN, SUMIRAN or remembering God’s name i.e. one's true self)!
NAMASMARAN rectifies our physical needs, passions, feelings, motivations, thoughts; and vision (perspective) and thus rectifies our behavior. This in turn leads to a continuous development of holistic health, which means; prosperity and profundity in individual and social life i.e. individual and global blossoming.
However; NAMASMARAN is not a pill or a tincture; and does not produce any tangible results! It is an invisible and intangible process of reaching and rejuvenating the seed (NAMA); of the tree (our individual and universal existence); and flowering and fruiting (in the form individual and universal blossoming).
I am away from holistic health. But like an ailing doctor; I too can prescribe this “key instruction” to the doctors, parents, teachers, leaders; to make their prescriptions to their patients, children, students and followers respectively; holistic! As it is from my Guru, and I won’t be at peace without doing so!

STRESS AND NAMA SANKALP

DR SHRINIWAS KASHALIKAR
We often feel that the ultimate destination of life; is beyond SANKALP (a kind of motivation, purpose, plan, aspiration, desire, ambition, determination etc, which leads to a variety of activities in life). Hence; we are often skeptical and/or cynical about NAMASANKALP (a planning of specific count in certain specific time; of NAMASMARAN); by an individual or a group.
Even as this is natural; we have to realize that; most of us; are not really freed from every kind of SANKALP. In fact; we are knowingly or unknowingly; and consciously or subconsciously involved; in several trivial preoccupations, which drag us away from our true selves. This is a root cause of stress, which manifests in different ways.
These preoccupations cannot be conquered by any voluntary effort; as they are intricately mingled with our ego.
This can only be done; if we consciously adopt a powerful SANKALP; that can nullify these preoccupations and catalyze surrender to our Guru (Self realization, Total Stress Management)! Such infinitely powerful SANKALP; is the time tested NAMASANKALP. This can save us from succumbing to our ego and stress; and empower us to reach the ultimate destination of life; beyond SANKALP!

We need not believe in this; but verify it by practice.

What Is an Incisional Hernia?
An incisional hernia happens when a weakness in the muscle of the abdomen allows the tissues of the abdomen to protrude through the muscle. The hernia appears as a bulge under the skin, and can be painful or tender to the touch. In the case of an incisional hernia, the weakness in the muscle is caused by the incision made in a prior abdominal surgery. An incisional hernia is typically small enough that only the peritoneum, or the lining of the abdominal cavity, pushes through. In severe cases, portions of organs may move through the hole in the muscle.
Who Is At Risk For an Incisional Hernia?
Incisional hernias are most likely to occur in obese and pregnant patients. A history of multiple abdominal surgeries may increase the risk of an incisional hernia. If a hernia develops in the abdomen and the patient has not had surgery, it is not an incisional hernia.
A patient who gains significant weight after an abdominal surgery, becomes pregnant or participates in activities that increase abdominal pressure like heavy lifting is most at risk for an incisional hernia. The incision is weakest, and most prone to a hernia, while it is still healing. While incisional hernias can develop or enlarge months or years after surgery, they are most likely to happen 3-6 months after surgery.

Diagnosing an Incisional Hernia
Incisional hernias happen after an abdominal surgery and may seem to appear and disappear, which is referred to as a "reducible" hernia. The hernia may not be noticeable unless the patient is involved in an activity that increases abdominal pressure, such as coughing, sneezing, pushing to have a bowel movement, or lifting a heavy object. The visibility of a hernia makes it easily diagnosable, often requiring no testing outside of a physical examination by a physician. The physician may request that you cough or bear down in order to see the hernia while it is "out".
Routine testing can be done to determine what area of the body is pushing through the muscle. If the hernia is large enough to allow more than the peritoneum to bulge through, testing may be required.
Incisional Hernia Treatment
An incisional hernia may be small enough that surgical repair is an option, not a necessity. If the hernia is large, causes pain or is steadily growing, surgery may be recommended. Another option is a truss, a garment that is similar to a weight belt or girdle, that applies constant pressure to the hernia.

When Is Incisional Hernia Surgery Necessary?
An Incisional hernia may require surgery if:
It continues to enlarge over time
It is very large
It is cosmetically unappealing
The bulge remains even when the patient is relaxed or laying down
The hernia causes pain

When Is Incisional Hernia an Emergency?
A hernia that gets stuck in the “out” position is referred to as an incarcerated hernia. While an incarcerated hernia may not be an emergency, medical care should be sought as it can become an emergency quickly. An incarcerated hernia becomes an emergency when it becomes a “strangulated hernia” where the tissue that bulges out is being starved of its blood supply. Untreated, a strangulated hernia can cause the death of the tissue that is bulging through the hernia.
A strangulated hernia can be identified by the deep red or purple color of the bulging tissue. It may be accompanied by severe pain, but is not always painful. Nausea, vomiting, diarrhea and abdominal swelling may also be present.

Incisional Hernia Surgery
Incisional hernia surgery is typically performed using general anesthesia and is done on an inpatient basis. The surgery is typically performed using the laparoscopic method, using small incisions rather than the traditional large open incision. Surgery is performed by a general surgeon or a colon-rectal specialist.

Once anesthesia is given, surgery begins with an incision on either side of the hernia. A laparoscope is inserted into one incision, and the other incision is used for additional surgical instruments. Dr. B C Shah then isolates the portion of the abdominal lining that is pushing through the muscle. This tissue is called the “hernia sac”. Dr. B C Shah returns the hernia sac to its proper position, then begins to repair the muscle defect.
If the defect in the muscle is small, it may be sutured closed. The sutures will remain in place permanently, preventing the hernia from returning. For large defects, the Dr. B C Shah may feel that suturing is not adequate. In this case, a mesh graft will be used to cover the hole. The mesh is permanent and prevents the hernia from returning, even though the defect remains open.
If the suture method is used with larger muscle defects (approximately the size of a quarter or larger), the chance of reoccurrence is increased. The use of mesh in larger hernias is the standard of treatment, but it may not be appropriate if the patient has a history of rejecting surgical implants or a condition that prevents the use of mesh.
Once the mesh is in place or the muscle has been sewn, the laparoscope is removed and the incision can be closed. The incision is typically closed with sutures that are removed at a follow up visit with the Dr. B C Shah, a special form of glue that is used to hold the incision closed without sutures or small sticky bandages called steri-strips.

Recovering From Incisional Hernia Surgery
Most hernia patients are able to return to their normal activity within two to four weeks. The belly will be tender, especially for the first week. During this time the incision should be protected during activity that increases abdominal pressure by applying firm but gentle pressure on the incision line. This is especially important for incisional hernia patients, as they are predisposed to an incisional hernia and can be at risk for another one at the new incision sites.
Activities during which the incision should be protected include:
Rising from a seated position
Sneezing
Coughing
Bearing down during a bowel movement. Contact Dr. B C Shah if you are constipated after surgery, a stool softener may be prescribed.
Vomiting
Lifting heavy objects